406215266-11-22-2022-17-CC-EBAY-CLERKM-20221122120545

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215266
Report Date: 11/22/2022
Date Signed: 11/22/2022 12:06:29 PM

Document Has Been Signed on 11/22/2022 12:06 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	COUNTRY COTTAGE PRESCHOOL		FACILITY NUMBER:	406215266
ADMINISTRATOR:	BRIANNA MALLORY		FACILITY TYPE:	850
ADDRESS:	2075 JOHNSON AVENUE		TELEPHONE:	(805) 235-2153
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	62	CENSUS: 32	DATE:	11/22/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Kimberly Barrientos		TIME COMPLETED:	12:15 PM

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On 11/22/22, at 8:45 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Child Care Center (CCC). The LPA met with Kimberly Barrientos, Assistant Director of the CCC and explained the purpose of the inspection. LPA, in the company of Assistant Director, toured the interior and exterior of the CCC. The CCC operates from 7:45 AM to 5:30 PM, Monday - Friday. The preschool uses three classrooms (2 year old-3 year old Classroom and 4 year old - 5 year old Classroom and 3 year old classroom) for care. At the time of the inspection, LPA observed 32 children in care along with 8 teachers (cleared and associated) providing care and supervision.

Classrooms of the CCC are observed to be clean, organized and orderly. All classrooms have age appropriate toys and furnishings available for children in care. Each classroom has carbon monoxide detectors. A carbon monoxide detector in the 4 year old- 5 year old Classroom was tested at 9:51 AM and found to be operable The bathrooms in the CCC are in safe and sanitary operating condition. The attached kitchen was observed to be clean and free of toxins. Food and beverages capable of spoiling were stored in an operable refrigerator. Food items are also dated. Disinfectants and cleaning solutions are observed on elevated locations in each classroom which is beyond the reach of children in care. Assistant Director informed LPA no medication is stored on site, however when medication is present the medication is secured in the Director's office.

The CCC provides morning and afternoon snacks for the children. Children bring lunch from home. Staff members inspect children's lunches to ensure lunches contain the essential food groups and are void of junk foods. LPA observed required licensing notices and documents posted predominately at the entry of the CCC. Additionally LPA observed Sign In/Out forms which contained the children's arrival and departure times as well as the ignatures of authorized representatives.

The CCC outdoor playground areas in enclosed by a chain linked fence and have varied footing. The fence’s entry/exit gates are secured. LPA observed age appropriate toys/play equipment in the outdoor play areas

(CONT. LIC 809-C) .

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: COUNTRY COTTAGE PRESCHOOL	FACILITY NUMBER: 406215266
	VISIT DATE: 11/22/2022

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The toys/play equipment are in suitable condition and free of sharp, loose or pointed objects. The play structures in the playground areas have adequate cushioning materials to absorb falls and shade in the form of tress and building overhangs. No bodies of water were observed on site. There is available drinking water for children both inside the classroom and outside in the play area. The CCC provides bottle water to childre in care. The water source of the buildings are not in use and inaccessible to children, The Assistant Director was reminded to the need to test the facilities water sources for lead containments. Waste receptacles with tight fitting covers were observed throughout the CCC. A sampling of staff and children records were reviewed. The children’s records were complete and found to contain emergency contact information and children immunization records. LPA notes the CCC has no children under the age of 2 years old. Staff records were reviewed and contained documentation to support their educational experience and training certifications. Assistant Director noted no firearms/weapons or ammunition was stored on the premises.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an for additional resource. LPA also informed Assistant Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Facility representative were reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility representative Kimberly Barrientos

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC809 (FAS) - (06/04)

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